Personalized medicine has gained significant attention over the last decade as technologies for understanding biological differences
between individuals have advanced dramatically. There are many potential benefits of personalized medicine including minimizing
risk of drug toxicity, increasing benefit from drugs used, contributing to the sustainability of the healthcare system and facilitating drug
discovery and development programs. Unfortunately there are also many barriers such as cost, complexity, high quality evidence requirements,
and the need for further education that have limited the clinical translation of pharmacogenomic tests to date. Issues that need
to be clarified are also considered, such as the regulatory evidence requirements for pharmacogenomic tests and the need for multiple
pathways and for pharmacogenomic marker development. These issues surrounding personalized medicine are contextualized using three
contemporary examples of pharmacogenetic tests involving drug metabolising enzymes: UDP glucuronosyltransferase 1A1 and irinotecan
toxicity, cytochrome P450 2C19 and clopidogrel efficacy, and cytochrome P450 2C9 and warfarin dosing.
Keywords: Barriers, clinical utility, drug metabolism, personalized medicine, pharmacogenomics, pharmacogenetics.
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